Psych: Sleep Disturbances Flashcards
1
Q
- Dyssomnia
- Anxiety about not getting enough sleep exacerbates the condition
- Problems falling asleep and/or staying asleep
- Occurs > 3 times/week for at least 1 month
- Tx: Maintain sleep hygiene (regular sleep schedule, limit caffeine), Diphenhydramine, Zolpidem, Zaleplon, Trazodone (short term)
A
Primary Insomnia
2
Q
- Dyssomnia
- Excessive daytime sleepiness or Excessive sleep for at least 1 month
- Onset often in Adolescence
- Tx: Amphetamines (stimulants) then SSRIs
A
Primary Hypersomnia
3
Q
- Dyssomnias
- Disordered regulation of sleep-wake cycles - characteristic is excessive daytime sleepiness
- Decreased Orexin production in Lateral Hypothalamus
- Sudden sleep attacks (repeated) during the day for at least 3 months
- A/w Cataplexy (Sudden collapse while awake, Loss of voluntary muscle tone follwoing a stong emotional stimulus: laughter), Short REM latency, Sleep paralysis, Hypnagogic (going to) and **Hypnopompic **(post-sleep) Hallucinations
- Immediately go into REM sleep w/out passing through Stages N1 – N4
- Uncommon, Childhood or Adolescence, Possibly genetic
- Tx: Schedules daytime naps, Amphetamines, Modafinil, Nighttime sodium Oxybate (GHB), Methylphenidate (stimulants), SSRIs or Sodium Oxalate for Cataplexy
A
Narcolepsy
4
Q
- Dyssomnia
- Disparity between circadian Sleep-wake cycle and Environmental sleep demands (eg. Jet lag, Night shifts)
- Seen in frequent travelers and Shift work
- Tx: Remission, esp. in pts. Suffering from Jet lag (1 wk), Light therapy (for shift workers), Melatonin (5 hrs before bedtime)
A
Circadian Rhythm Sleep Disorder
5
Q
- Dyssomnia
- Abnormal sleep ventilation (Central or Obstructive), Somnolence or Hypersomnia
- Stops breathing for at least 10 seconds repeatedly
- A/w Obesity, Pulm. HTN, Arrythmias
- Tx: CPAP machine, Surgery (Nasal or Uvulopalatopharyngoplasty), Weight loss, Mechanical ventilation
A
Sleep Apnea
6
Q
- Ventilation is disrupted by Physical obstruction
- Pts. have respiratory effort, but airway obstruction prevents air from getting into the lungs
A
Obstructive Sleep Apnea
7
Q
- Little or no respiratory effort is made
- The Medulla does not respond to Increasing lvls of CO2
A
Central Sleep Apnea
8
Q
- Parasomnia
- Repeat Nightmares and Recalling the details of the Dream, causes Distress
- Occurs during REM sleep
- Onset w/ Childood
- Increases w/ times of Stress
- Tx: TCAs to suppress total REM sleep
A
Nightmares
9
Q
- Parasomnia
- Pts. w/ extreme Frightfulness during sleep
- Pts. have no recollection of these sleep episodes
- Occurs in Stage 3 or 4 of sleep cycle
- More w/ Children (Boys > Girls)
- Genetic
- Tx: Diazepam (Valium) at Bedtime
A
Night Terrors
10
Q
- Parasomnia
- Walking duirng sleep
- Pts. have blank stare
- A/w other behaviors (dressing, talking)
- Pt. can be awoken w/ great difficulty, confused w/ no recollection
- Ep. During Stage 3 or 4 w/ Sleep cycle
- Onset during Childhood (pk. @ 12 y.o.)
- Boys > Girls
- Genetic
- Tx: None
A
Somnambulism
(Sleepwalking)
11
Q
Depression
A
- Normal sleep onset
- Early morning awakenings (ie. waking up before the pt. desires)
- Decreased REM latency
- Increased total REM sleep
- Decreased Slow-wave sleep
- Overall decreased sleep
12
Q
Bipolar Disorder
A
- Difficulty initiating sleep
- Needs less sleep during manic episodes
13
Q
Anxiety Disorder
A
- Difficulty initiating sleep
14
Q
Caffeine
A
- Most common cause of insomnia
15
Q
Benzodiazepines
(Diazepam, Lorazepam, Midazolam, Chonazepam)
A
- Insomnia (upon discontinuation - withdrawal symptom)
- Nightmares and other sleep disturbances, Including Restless legs syndrome
- Nocturnal myoclonus
- Hypnagogic hallucinations (transitional state between sleep and wakefullness)
